藏药乌奴龙胆质量标准研究

乌奴龙胆为常用的藏药,但其质量标准仅有性状鉴别项。作为2015年版《中国药典》民族药质量标准提高的拟定品种,该研究建立该品种质量控制方法与标准。参照《中国药典》2010年版附录相关方法,对乌奴龙胆药材水分、灰分、酸不溶性灰分及醇溶性浸出物进行测定;以乌奴龙胆苷A为对照物质,建立薄层鉴别方法;采用HPLC建立主要成分乌奴龙胆苷A的含量测定方法。结果以三氯化铝试液为显色剂,乌奴龙胆中各成分在紫外光灯(366 nm)下检视,能得到较好的分离,在与对照品的相应位置上显示相同的颜色荧光斑点;含量测定方法学研究结果表明,乌奴龙胆苷A在0.009 95~0.398 g·L^-1呈良好的线性关系,回归方程为Y=1 467.1X+41.407 (r=0.999 9),平均回收率为98.3%(RSD 2.2%)。15批乌奴龙胆药材样品的测定结果表明,乌奴龙胆苷A的质量分数为0.175%~1.83%;醇溶性浸出物为29.2%~35.2%,水分为8.60%~9.93%;10批代表性样品总灰分范围在10.2%~17.2%;酸不溶性灰分范围在5.26%~10.8%。以上结果表明建立的标准具有较好的专属性和准确性,可用于乌奴龙胆药材的质量控制。建议规定乌奴龙胆药材的水分含量不超过12.0%;总灰分不得过15.0%;酸不溶性灰分不得过8.0%;浸出物不得少于26.0%;含乌奴龙胆苷A(C₄₀H₅₂O₂₂)不得少于0.80%。     

玄参子芽分级标准研究

对全国玄参主产区子芽的长、粗和重3个形态指标进行检测,使用SPSS统计软件,通过聚类分析制定玄参子芽的质量分级标准。田间试验观测不同等级子芽玄参的植株生长情况及产量。田间试验表明,Ⅰ级玄参长势最好,产量最高,Ⅲ级玄参长势最差,产量最低。玄参药材中主要活性成分含量测定结果表明不同等级的子芽对药材的内在品质无明显影响。为保证高产及减少成本,玄参生产用子芽应控制在Ⅱ级以上。此方法制定的质量分级标准科学、可行,可作为玄参子芽的质量控制标准,为玄参规范化栽培提供依据。     

关于厚朴药材商品规格等级标准的研究

通过市场调查和文献研究,了解厚朴药材商品状况;同时采集样品进行分析,结合生产实际,制定新的厚朴商品规格等级标准。现行的规格等级标准中,将厚朴药材按来源划分为温朴与川朴2个品别,再按取皮部位划分为4种规格,每一种规格又按长度和质量划分若干等级;判断厚朴药材质量优劣的依据主要是性状特征(外观质量)。在新制定的厚朴商品标准中,等级的划分则是以厚度、厚朴酚与和厚朴酚含量为依据,即综合外观性状与药效成分(内在品质),科学评价药材质量。由于温朴与川朴的商品性状特征基本一致,外观难以区分,不再划分品别;又因蔸朴与耳朴部位重叠,规格简化为筒朴(含枝朴)、根朴、蔸朴等3种;其中,筒朴分为3个等级,根朴、蔸朴不分等(统货)。     

藏医学药用唇形科植物药材品种与标准整理

对藏医学中药用唇形科植物的品种、基原及标准状况进行了分析整理.结果表明,相关文献记载的藏医学药用的唇形科植物共有21属71种(含变种),涉及44个药材品种,其中与中药交叉使用的品种7个,约占9.9％;在我国现行各级药材标准中收载的药材品种19个,约占43％;涉及的其原植物有27种,约占38％.在藏药的标准和文献中,药材的藏文名称和藏文音译汉文名称用字以及其原植物物种存在着较大的差异.除少数几种与中药材交叉使用的品种在《中国药典》中有比较完善的标准规定外,而在《部颁标准·藏药分册》、《藏药标准》及地方标准中收载的品种仅有性状、显微或理化鉴别等项规定,标准极不完善.通过文献考证、资源和使用现状调查,结合现代药学研究推动藏药材的品种-其原规范、质量标准体系建立是当前迫切需要开展的工作.     

《备急千金要方》治疗颜面损美性疾病用药规律初探

目的:通过对《备急千金要方》治疗颜面损美性疾病80首方剂药物规律研究,分析孙思邈治疗颜面损美性疾病的用药特点.方法:以《备急千金要方·卷六·七窍病·面药第九》治疗颜面损美性疾病80首方剂为研究对象,对方剂的用药、剂型、性味归经、功效等进行统计分析,统计分析方剂中药物的使用频次、性味、归经、功效、剂型、治法等.结果:白芷使用频次最高,其次是白附子、酒、川芎等;药物归经以脾胃经和肺经为主,肝经次之;温性药物较多,甘、辛二味占多数;所用药物多有祛风、燥湿、利水、化痰、散寒、活血、行气、通经等功效;用糊剂进行敷涂为主要治疗方法.结论:颜面损美性疾病发病在浅表皮肤,多属肌肤失养,可从肺脾论治,可用甘温、辛温药物治疗,取其温经通络、调达气血之意,使用糊剂有利于药物吸收,且保护创面、维持皮肤湿度.     

Nicotine Evoked Currents in Human Primary Sensory Neurons

Sensory neuron nicotinic acetylcholine receptors (nAChRs) contribute to pain associated with tissue injury. However, there are marked differences between rats and mice with respect to both the properties and distribution of nAChR currents in sensory neurons. Because both species are used to understand pain signaling in humans, we sought to determine whether the currents present in either species was reflective of those present in human sensory neurons. Neurons from the L4/L5 dorsal root ganglia were obtained from adult male and female organ donors. Nicotine evoked currents were detected in 40 of 47 neurons (85%). In contrast with the naïve mouse, in which almost all nAChR currents are transient, or the rat, in which both mouse-like transient and more slowly activating and inactivating currents are detected, all the currents in human DRG neurons were slow, but slower than those in the rat. Currents were blocked by the nAChR antagonists mecamylamine (30 µmol/L), but not by the TRPA1 selective antagonist HC-030031 (10 µmol/L). Single cell polymerase chain reaction analysis of nicotinic receptor subunit expression in human DRG neurons are consistent with functional data indicating that receptor expression is detected 85 ± 2.1% of neurons assessed (n = 48, from 4 donors). The most prevalent coexpression pattern was α3/β2 (95 ± 4% of neurons with subunits), but α7 subunits were detected in 70 ± 3.4% of neurons. These results suggest that there are not only species differences in the sensory neuron distribution of nAChR currents between rodent and human, but that the subunit composition of the channel underlying human nAChR currents may be different from those in the mouse or rat.PerspectiveThe properties and distribution of nicotine evoked currents in human sensory neurons were markedly different from those previously observed in mice and rats. These observations add additional support to the suggestion that human sensory neurons may be an essential screening tool for those considering moving novel therapeutics targeting primary afferents into clinical trials.     

招收飞行学员体格检查标准适宜性评估

目的 评估招收飞行学员体格检查标准能否满足飞行学员医学选拔的需要.方法 分3个步骤实施招收飞行学员体格检查标准的评估.第一步,编制调查手册.根据标准条款适宜性评估涉及的主要因素,编制由适宜性评估及使用情况调查两部分内容组成的调查手册.第二步,筛选专家.采用社会调查学的方法,选择119名专家(其中招飞体检专家98人,航空临床医学专家21人)对359个标准条款进行适宜性评估,并分析评估结果的可靠性.第三步,制定判断标准.根据专家的选择来判断条款的价值.若某一标准条款被超过80％以上的专家评估为适宜,则适宜性高;若低于60％,则适宜性低.结果 发放调查手册134份,回收128份,专家参加评估的积极指数为0.95,而权威系数=0.86.在359个条款中,有271条(占75.5％)的适宜性获得专家认可,而有27条(占7.5％)未得到专家的普遍认可,多为不易把握的功能评价条款.结论 尽管“招飞标准”大多数条款的适宜性获得专家认可,但仍有少数条款的适宜性不被专家普遍接受,应结合实际使用情况予以重点关注.     

Accuracy of multi-slice computed tomography for measurement of left ventricular ejection fraction compared with cardiac magnetic resonance imaging and two-dimensional transthoracic echocardiography: a systematic review and meta-analysis

Background

Multi-slice computed tomography (MSCT) allows non-invasive assessment of the coronary arteries and simultaneously can provide measurement of left ventricular ejection fraction (LVEF). The accuracy of newer MSCT generations (64-slice or more) for assessment of LVEF compared with magnetic resonance imaging (MRI) and two-dimensional transthoracic echocardiography (TTE) has not been evaluated in a meta-analysis.

Purpose

To evaluate, via a systematic literature review and meta-analysis, whether MSCT can assess LVEF with high accuracy compared with MRI and TTE.

Methods

Electronic databases and reference lists for relevant published studies were searched. Twenty-seven eligible studies provided mean LVEF% with its standard deviation (SD) measured by MSCT versus MRI and TTE. Meta-analysis of weighted mean difference (WMD) and Bland–Altman method were used to quantify the mean difference and agreement between MSCT compared with MRI and TTE.

Results

The results of combining 12 studies showed no significant difference in LVEF% between MSCT and MRI with a WMD of −0.11 (−1.48, 1.26, 95% CI), p = 0.88. Bland–Altman analysis showed excellent agreement between MSCT and MRI with a bias of 0.0 (−3.7, 3.7 ± 1.96SD) with 95% CI. The results of combining 15 studies showed no significant difference in LVEF between MSCT versus TTE measurements with a WMD of 0.19 (−1.13 to 1.50; 95% CI), p = 0.87. Bland–Altman analysis showed excellent agreement between MSCT and TTE with a bias of 0.3 (−4.7, 5.7 ± 1.96SD) with 95% CI.

Conclusion

The newer MSCT generations can provide accurate LVEF measurement compared to MRI and TTE. MSCT represents a valid technique for the combined evaluation of LVEF and coronary artery disease.     

Unilateral lower lung field opacities on chest radiography: a comparison of the clinical manifestations of tuberculosis and pneumonia

Background

The radiological manifestations of lower lung field (LLF) tuberculosis (LLFTB) are similar to those of LLF pneumonia (LLFP), making diagnosis challenging. The aim of this study was to determine if there are differences in the clinical manifestations of LLFTB and LLFP in patients with unilateral LLF opacities.

Methods

We performed a retrospective review of patient records to identify those with unilateral LLF opacities who were subsequently diagnosed with LLFTB or LLFP. We compared demographics, clinical manifestations, hematological data, and radiographic findings between the groups of patients.

Results

We identified 22 and 72 patients diagnosed with LLFTB and LLFP, respectively. Multivariate analysis revealed that age (odds ratio [OR] = 1.05, 95% confidence interval [CI] = 0.99–1.11, P = 0.072), lack of fever > 38 °C (OR = 9.04, 95% CI = 1.69–48.40, P = 0.001), duration of symptoms ≥ 7 days (OR = 4.57, 95% CI = 1.09–19.26, P = 0.038), and the lack of air bronchograms upon radiography (OR = 12.08, 95% CI = 1.98–73.64, P = 0.007) were significant predictors of LLFTB in patients with LLF opacities. We used these predictors to construct a mathematical model for predicting LLFTB in patients with LLF opacities.

Conclusions

Our findings suggest that older age, prolonged duration of symptoms, lack of fever > 38°C, and the absence of air bronchograms are more common in patients with LLFTB than patients with LLFP. These findings may help clinicians differentiate between LLFTB and LLFP and thus initiate timely and appropriate treatment.     

全手皮肤脱套伤的分型和治疗

目的总结全手皮肤脱套伤的伤情特点,探讨全手皮肤脱套伤的分型标准及治疗方法。方法 1999年12月-2010年5月,收治41例全手皮肤脱套伤。男28例,女13例;年龄18～58岁,平均35岁。致伤原因:碾压伤28例,挤压伤13例。受伤至手术时间1～10 h,平均3 h。根据自定全手皮肤脱套伤分型标准:Ⅰ型11例,Ⅱ型5例,Ⅲ型4例,Ⅳ型8例,Ⅴ型13例。Ⅰ型采用吻合血管回植术;Ⅱ型采用带足背皮瓣的甲瓣、第2趾甲瓣再造术;Ⅲ型采用双足带足背皮瓣的第2趾甲瓣再造术;Ⅳ型采用吻合血管回植术;Ⅴ型采用带足背皮瓣的甲瓣再造(8例)或腹部皮瓣修复术(5例)。足背皮瓣切取范围为9 cm×6 cm～17 cm×11 cm,足背供区游离植皮修复。结果术后Ⅰ型6例发生部分手指坏死,Ⅳ型6例发生部分手指及手掌皮肤坏死;其余患者皮瓣、再造指及回植皮肤均成活。足背供区及腹部供区均顺利愈合。40例患者获随访,随访时间6个月～7年,平均14个月。采用吻合血管回植治疗者,手部皮肤颜色、质地接近正常,功能恢复佳,感觉恢复至S2～S4;采用甲瓣及趾甲瓣再造手指者,手功能基本恢复,再造指感觉恢复至S2～S3;采用腹部皮瓣者,手功能恢复欠佳,手部感觉恢复至S1～S2。结论采用自定标准对全手皮肤脱套伤程度进行分型,并指导临床治疗方案的选择,可获得较好临床疗效。